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Ideal, Adjusted and Lean Body Weight

Ideal, Adjusted and Lean Body Weight

Calculation of body weight adjustments

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General description
Calculation of the dosing weight differs between underweight, average weight, and obese patients. The patient’s weight is assumed to confer information regarding a number of variables that ensure the appropriate quantity of treatment is delivered to the patient, reducing the risk of harm whilst ensuring treatment is efficacious. This tool calculates the ideal, adjusted and lean body weight.

Ideal body weight (IBW) was initially derived from insurance data and it represented the weight for a given height that was associated with the lowest mortality. The formula has been further refined since then. Now it is defined as the goal weight at which nutritional requirements are met. The formula used to calculate the IBW is only an approximation and is applicable only for people taller than 152 cm.

Adjusted body weight (AdjBW) in the context of obesity is defined as the weight that represents the metabolically active lean body tissue and therefore prevents over- or underestimation of nutritional requirements in the obese subject. It is used for patients whose weight is ≥ 120 % of their IBW.

Lean body weight (LBW) describes the mass of non-fatty cells and connective tissue. It appears to represent a convincing scientific estimate of body size. The calculation of LBW is not applicable to individuals with abnormal body water composition (e.g. fluid overload) and it was not validated in individuals of extreme height or weight, in those with highly muscular builds, or in underweight individuals.

Formula

Ideal body weight
Male: IBW [kg] = 50 kg + 2.3 kg × (height [in] - 60)
Female: IBW [kg] = 45.5 kg + 2.3 kg × (height [in] - 60)
1 cm = 0.3937007874 in
Adjusted body weight
AdjBW = IBW + 0.4 x (weight - IBW)
Lean body weight
Male: LBW [kg] = (9270 x weight [kg]) / (6680 + (216 x BMI [kg/m²]))
Female: LBW [kg] = (9270 x weight [kg]) / (8780 + (244 x BMI [kg/m²]))
BMI [kg/m²] = weight [kg] / (height [cm] / 100)²

References

Devine BJ. Gentamicin therapy. Drug Intell Clin Pharm 1974; 8:650
Janmahasatian S, Duffull SB, Ash S, Ward LC, Byrne NM, Green B. Quantification of lean bodyweight. Clinical Pharmacokinetics. 2005;44(10):1051–65.
Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clinical Pharmacokinetics. 2010;49(2):71–87.
Erstad BL. Dosing of medications in morbidly obese patients in the Intensive Care Unit Setting. Intensive Care Medicine. 2004;30(1):18–32.

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Calculation of the dosing weight differs between underweight, average weight, and obese patients. The patient’s weight is assumed to confer information regarding a number of variables that ensure the appropriate quantity of treatment is delivered to the patient, reducing the risk of harm whilst ensuring treatment is efficacious. This tool calculates the ideal, adjusted and lean body weight.

Ideal body weight (IBW) was initially derived from insurance data and it represented the weight for a given height that was associated with the lowest mortality. The formula has been further refined since then. Now it is defined as the goal weight at which nutritional requirements are met. The formula used to calculate the IBW is only an approximation and is applicable only for people taller than 152 cm.

Adjusted body weight (AdjBW) in the context of obesity is defined as the weight that represents the metabolically active lean body tissue and therefore prevents over- or underestimation of nutritional requirements in the obese subject. It is used for patients whose weight is ≥ 120 % of their IBW.

Lean body weight (LBW) describes the mass of non-fatty cells and connective tissue. It appears to represent a convincing scientific estimate of body size. The calculation of LBW is not applicable to individuals with abnormal body water composition (e.g. fluid overload) and it was not validated in individuals of extreme height or weight, in those with highly muscular builds, or in underweight individuals.
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